| Objective: To explore the effect of traditional Chinese medicine on its survival time and the risk factors affecting the prognosis of patients with hepatic encephalopathy(HE),clinical factors related to the occurrence,development and prognosis of HE were observed and analyzed through a retrospective cohort study aiming to provide evidence-based support for HE treatment and useful reference for its prognosis evaluation.Methods: A total of 127 eligible patients who were hospitalized in the department of infectious disease of the Affiliated Hospital of Cheng Du University of Traditional Chinese Medicine within the period from Jan 1,2016 to Dec 30,2019 were selected.The date of initial diagnosis of HE was taken as the starting point of follow-up to observe the survival time and medications of each patients.The survival in 1 year after the diagnosis were collected along with the clinical data at the time of the HE onset.Based on the treatment agent the patients received(the level of receiving TCM treatment),the study cohort were divided in to two groups.The survival differences between groups were compared by survival analysis.Cox Proportional Risk Model was applied to analyze 13 factors that may be related to the survival risk of HE to screen out the independent risk factors.Results:(1)The average survival time and median survival time within 1 year in the high exposed group were 205 days and 213 days respectively,while those in the lowly exposed group were 146 days and 48 days respectively.The 30-day,90-day,180-day and 365-day cumulative survival rate in the high exposed group were82.9%,61.4%,54.3% and 41.4%,respectively while the lowly exposed group were57.9%,45.3%,41.7%and 27.2% respectively.The difference was statistically significant(P < 0.05).(2)With the patients in stage III HE,the 30-day,90-day,180-day and 365-day cumulative survival rate in the high exposed group were 68.6%,40.0%,28.6% and17.1%,respectively while the lowly exposed group were 40.0%,22.2%,18.5%and 7.4%respectively.The difference was statistically significant(P < 0.05).(3)The level of receiving TCM treatment,Hepatic Carcinoma(HCC)and Ch E concentration are independent factors affecting one-year survival of HE patients(p<0.05).among these factors,Ch E is irrelevant while HCC(HR : 1.66,95%CI :1.00-2.75)is independent risk factors.TCM treatment(HR=0.56,95%CI: 0.36-0.89)is a protective factor.Conclusion:(1)Receiving high exposure of TCM treatment could significantly improve the survival time of HE patients within 1 year and the cumulative survival rate of 30-day,90-day,180-day,and 365-day.(2)Receiving high exposure of TCM treatment could significantly improve 1-year survival of patients with HE.(3)Hepatic carcinoma is independent risk factors for the prognosis of HE.Combining with hepatic carcinoma could impose a negative impact on the long-term survival. |
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